Study On The Establishment Of Evaluation System For Operation And Management Of New Rural Coorperative Medical Scheme At Provincial Level Based On Analytic Hierarchy Process

Objective:The purpose of this dissertation is to set up an evaluation index system aiming at the operation and management of New Rural Coorperative Medical Scheme (hereafter referred to as NRCMS) at Provincial Level through several scientific methods, the data of which is provided by quarterly or annal NRCMS reports, in order to provide support for national or provincial administration to carry out supervision and management, as well as decision-making for NRCMS.Contents:1. The framework of the evaluation system for the operation and management of NRCMS.2. The establishment of the evaluation system for operation and management of NRCMS at provincial level. Make sure the principles for building the index system, and search out the primary indexes. Then select and supplement the primary indexes in order to establish a set of layered evaluation indexes, each of which has an explicit definition and calculation method. Then calculate the weight and combined weight of each index.3. The attribute and reference values of each index, and the synthetic evaluation model.4. The raliabilitity, the validity as well as the discrimination of the evalution system by use of several provinces’NRCMS reports. Methods:1. Document Analysis is ued to set up the framework of the evaluation system for the operation and management of NRCMS, and to search out the primary indexes2. Delphi Method is ued to select and supplement the primary indexes in order to establish a set of layered evaluation indexes.3. Analytic Hierarchy Process is ued to calculate the weight and combined weight of each index.4. Synthetic Index Method is ued to build up the synthetic evaluation model.5. Some mathematical or statistical methods is ued to test the evaluaiton system, such as Cronbach’s a Coefficient, Factor Analysis, Hierarchy Analysis, Analysis of Variance.Results:1. The framework of the evaluation system for the operation and management of NRCMSWe have selected7aspects to establish the framework of evaluation index system, that is coverage, finacing, fund allocation and expenditure, the degree of benefit, burden of medical expenses, medical service use as well as medical expense control. The subject of the evaluation:the central or provincial administration of NRCMS. The object of the evalution:the operation and management of NRCMS at provincial level, that is all the aspects during the implement of NRCMS, including participation, financing, compensation, as well as the guidance for medical service and the control of medical expense.2. The evaluation system for operation and management of NRCMS at provincial levelThe principles for building the index system:scientificalness, practicability, comprehensiveness, guidance and dynamics. After two-round Delphi consult,7indexes and27subordinate indexes are formulated. The name of the7indexes are coverage, finacing, fund allocation and expenditure, compensation and benefit, burden of medical expenses, medical service use as well as medical expense control. Through Analytic Hierarchy Process, the weights and combined weights of7indexes and27subordinate indexes are caculated. 3. The synthetic evaluation modelThe attribute and reference values of each subordinate index have been defined. There are10positive indexes,10negetive indexes, and7moderate indexes. Chose evarage values of different areas or years as reference values. The standardization calculation fomula of each subordinate index has also been made. Comprehensive exponent value is the sum of each subordinate index’s standazation value multiply its combined weight. In order to increase the differentiation, we use Synthetic Score by expending the comprehensive exponent100times, which is the standard for the evaluation.4. The reliability, the validity and the discrimination test of the evaluaition system.Internal reliability analysis:The Cronbach’s a coefficients of7dimensions is between0.532and0.896, the he Cronbach’s a coefficient of total index system is0.773. Content validity analysis:the selected indexes include all aspects of the evalution, and the definitions and calculation methods of them are clear. Structrual validity analysis:7extracted common factors have a high load on the seven dimensions with an accumulated contribution to73.94%. Discrimination analysis:in cluster analysis, the samples are divided into5groups, ANOVA analysis showed that the differences among all5groups and between each2groups are statistically significant (P<0.05).Conclusions:1. The evaluation index system of operation and management of NRCMS has been established, which is able to be used in the regularily evaluation, and to some extent guide the work of NRCMS.2. A practical evaluation model has been built up in the study, which can be applied in the daily work.3. The raliabilitity, the validity as well as the discrimination of the evalution system are satisfactory, and the evalution system has the basic conditions for application.Suggestions:1. The NRCMS reports should be revised in accordance with the current focus of NRCMS, and the quality of it be improved. 2. Take full advantage of informationization to enlarge the data sources of indexes and to carry out the evaluation of NRCMS at regular time.3. Take the evaluation results objectively, and make good use of it to support decision-making.4. Focus on the dynamics of the evaluation on the NRCMS.